Active NPI
First Care Medical Clinic
- Internal Medicine Physician
- Rock Hill, SC
National Provider Identifier
1881989192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- FIRST CARE MEDICAL CLINIC
- Practice address
- 1462 Constitution Blvd
Rock Hill, SC 29732-3075 - Phone
- (704) 291-9267
- Fax
- (704) 283-7939
- NPI assigned
- Jun 15, 2011
- Last updated
- Sep 7, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Benedict Onwukwe Okwara
- Title
- Medical Director
- Phone
- (704) 291-9267
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | NU | ||
| Family Medicine Physician | 207Q00000X | NU | ||
| Internal Medicine Physician | 207R00000X | NU | Primary | |
| Pediatrics Physician | 208000000X | NU | ||
| Pediatric Adolescent Medicine Physician | 2080A0000X | NU | ||
| Podiatrist | 213E00000X | NU | ||
| Foot & Ankle Surgery Podiatrist | 213ES0103X | NU |
Addresses
Primary practice location
1462 Constitution Blvd
Rock Hill, SC 29732-3075
Mailing address
404 S Sutherland Ave
Monroe, NC 28112-5060
Phone (704) 291-9267
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2326436 | Other | NC | GROUP MEDICARE # |
| GP5781 | Medicaid | SC | |
| 025A7 | Other | NC | BCBS OF NC |
| 5917848 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110914000742 | SC | Part B Supplier - Clinic/Group Practice | 5395641823 |
Receives reassigned benefits from 13 practitioners Practice locations: Rock Hill, SC |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
dba First Care Medical Clinic
- Internal Medicine Physician
- Monroe, NC
- NPI 1689635237
5395641823
National Provider Directory
National Provider DirectoryLocations
1462 Constitution Blvd
Rock Hill, SC 29732
Phone (803) 909-4040
Practitioners & affiliated clinicians
Practitioners 14
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Family Nurse Practitioner
- Concord, NC
- NPI 1467091272
Family Medicine, SC
-
- Community/Behavioral Health Agency
- Gastonia, NC
- NPI 1326132804
Internal Medicine, SC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308096000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1346976000000",
"number": "1881989192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 S SUTHERLAND AVE",
"city": "MONROE",
"state": "NC",
"postal_code": "281125060",
"telephone_number": "704-291-9267",
"fax_number": "704-283-7939"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1462 CONSTITUTION BLVD",
"city": "ROCK HILL",
"state": "SC",
"postal_code": "297323075",
"telephone_number": "704-291-9267",
"fax_number": "704-283-7939"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIRST CARE MEDICAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2011-06-15",
"last_updated": "2012-09-07",
"status": "A",
"authorized_official_last_name": "OKWARA",
"authorized_official_first_name": "BENEDICT",
"authorized_official_middle_name": "ONWUKWE",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "704-291-9267",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP MEDICARE #",
"identifier": "2326436",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GP5781",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NC",
"identifier": "025A7",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5917848",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rock Hill, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.